Compared to the frenzy over human cloning a decade ago, in recent years the issue has received very little political attention, despite the recent breakthroughs in therapeutic cloning by US scientists (see BioNews 705 and 751). But as the ongoing fights over CRISPR and mitochondrial replacement show, some of the underlying debates about the ethics of genetic engineering and embryo experimentation are still with us.
A new report from the Witherspoon Council on Ethics and the Integrity of Science, a bioethics group consisting of several former members of George W. Bush's President's Council on Bioethics, makes the case for banning both reproductive and therapeutic cloning. The terms 'reproductive cloning' and 'therapeutic cloning' are not the ones used in the report, which opts instead for the terms 'cloning-to-produce-children' and 'cloning-for-biomedical-research'. As the report argues, the distinction between therapeutic and reproductive cloning is misleading because the creation of a cloned embryo is always a reproductive act – the embryo is a new organism, the progeny of the source from which it was cloned. And therapeutic cloning is never therapeutic for the cloned embryo, which is destroyed, and is not necessarily therapeutic for any particular patients.
Public opinion has always been squarely opposed to cloning-to-produce children, though some academics have defended cloning as an exercise of radical reproductive autonomy. But if there is ever a time when the interests of children should counter-balance the liberty interests of prospective parents, it is in the case of human cloning. The medical risks posed by cloning are well known, and the first experimental uses of cloning would pose unjustifiable risks to the children created.
Beyond the concerns with safety are deeper moral objections to the way cloning would transform procreation into a manufacturing process. This is not, as ethicists like Kerry Lynn Macintosh have suggested, a fallacious argument that cloning would inevitably produce 'defective products'. Rather, it is an argument that the relationship between the generations will be distorted by the way prospective parents will come to see cloned children as products to be shaped and controlled, accepted or rejected, rather than gifts to be loved unconditionally.
Although some states have prohibited human cloning (with some prohibiting only cloning-to-produce-children while others prohibit all forms of cloning), at the federal level cloning remains largely unregulated, largely because the controversy over whether to prohibit only cloning-to-produce-children or to pass a comprehensive cloning ban has stymied national legislative action. Some of the cloning laws proposed in the US Congress would have prohibited the transfer of cloned embryos to a woman's uterus. But as Gilbert Meilaender noted in 2002, such laws 'create a class of human beings whose destruction is mandated by law'. Creating human embryos with the express purpose of destroying them is even more problematic than the incidental destruction of embryos that occurs during IVF or the destruction of 'left-over' embryos in other forms of stem-cell research, making it very controversial for the US public.
Procuring human egg cells is another serious moral problem for human cloning research. Egg collection procedures pose health risks to women, and the practice of paying women for their eggs could lead to exploitation of those who might feel pressured to subject themselves to risk. Some ethicists have argued that compensation for oocytes is unlikely to provide an undue inducement and that compensation for the 'time, inconvenience, and discomfort associated with oocyte retrieval can and should be distinguished from payment for the oocytes themselves'. But cloning researchers have found that, in the absence of compensation, they are simply unable to find enough women willing to provide eggs for their research. Clearly, money induces women who would otherwise be unwilling to participate in egg collection procedures, which explains why researchers have sought to reform laws that restrict their ability to pay women for their oocytes.
However, there seems to be a way out of the ethical dilemma posed by cloning-for-biomedical research: the human induced pluripotent stem (iPS) cells first developed in 2007 provide a promising alternative that does not rely on the destruction of embryos. But cloning research continued after this discovery, and many scientists and ethicists have argued that iPS cells cannot replace cloning and other forms of embryonic stem (ES) cell research, since it is still not clear what types of cells will, in the end, work best for research and therapy.
Of course, pursuing both cloning and other forms of cell reprogramming would be reasonable if there were no ethical problems with either. But even if cloning offers some advantages over iPS cells, the availability of a comparable alternative weakens the case for permitting cloning. A ban on all forms of human cloning would not mean forgoing personalised regenerative medicine, but would, at worst, mean that progress in this field might be slower than it would be without a ban.
Also, the reasons for pursuing both lines of research can be overstated. Using existing ES cell lines, including those created through cloning, scientists could continue to compare the efficacy of the two types of cell lines, while studies of the basic mechanisms of reprogramming can still be conducted using animal models.
The USA has lagged behind other countries in its policies on assisted reproduction technologies (ART) for too long. A ban on human cloning is of course not a comprehensive ART policy, and emerging technologies like mitochondrial replacement, next-generation prenatal genetic screening , and genetic modification all deserve more public attention in the USA. But finally crafting a national cloning policy will be an important step toward treating the moral and social issues raised by ART with the seriousness they deserve.